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Normal Fasting Plasma Glucose Levels and Type 2 Diabetes in Young Men
Open accessAbstract
BACKGROUND: The normal fasting plasma glucose level was recently defined as less than 100 mg per deciliter (5.55 mmol per liter). Whether higher fasting plasma glucose levels within this range independently predict type 2 diabetes in young adults is unclear. METHODS: We obtained blood measurements, data from physical examinations, and medical and lifestyle information from men in the Israel Defense Forces who were 26 to 45 years of age. RESULTS: A total of 208 incident cases of type 2 diabetes occurred during 74,309 person-years of follow-up (from 1992 through 2004) among 13,163 subjects who had baseline fasting plasma glucose levels of less than 100 mg per deciliter. A multivariate model, adjusted for age, family history of diabetes, body-mass index, physical-activity level, smoking status, and serum triglyceride levels, revealed a progressively increased risk of type 2 diabetes in men with fasting plasma glucose levels of 87 mg per deciliter (4.83 mmol per liter) or more, as compared with those whose levels were in the bottom quintile (less than 81 mg per deciliter [4.5 mmol per liter], P for trend <0.001). In multivariate models, men with serum triglyceride levels of 150 mg per deciliter (1.69 mmol per liter) or more, combined with fasting plasma glucose levels of 91 to 99 mg per deciliter (5.05 to 5.50 mmol per liter), had a hazard ratio of 8.23 (95 percent confidence interval, 3.6 to 19.0) for diabetes, as compared with men with a combined triglyceride level of less than 150 mg per deciliter and fasting glucose levels of less than 86 mg per deciliter (4.77 mmol per liter). The joint effect of a body-mass index (the weight in kilograms divided by the square of the height in meters) of 30 or more and a fasting plasma glucose level of 91 to 99 mg per deciliter resulted in a hazard ratio of 8.29 (95 percent confidence interval, 3.8 to 17.8), as compared with a body-mass index of less than 25 and a fasting plasma glucose level of less than 86 mg per deciliter. CONCLUSIONS: Higher fasting plasma glucose levels within the normoglycemic range constitute an independent risk factor for type 2 diabetes among young men, and such levels may help, along with body-mass index and triglyceride levels, to identify apparently healthy men at increased risk for diabetes.
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“Men with FPG values of 4.83-5.05mmol/L (87-91 mg/dL) have a significantly increased risk of type 2 diabetes, compared with men with FPG values ,4.5 mmol/L (81 mg/dL).”
From Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus (2011) · cites this paper as [41]
In the citing paper
“More-recent evidence indicates that FPG concentrations even lower than 5.6 mmol/L (100 mg/dL) are associated with a graded risk for type 2 diabetes (41).”
From Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus (2011) · cites this paper as [41]
In the citing paper
“Although the prevalence of diabetes is low at these glucose concentrations, the data support the concept of a continuum between FPG and the risk of diabetes.”
From Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus (2011) · cites this paper as [41]
In the citing paper
“A categorisation of persons as either ‘normal’ or ‘prediabetic’ (IFG, IGT) neglects the fact that diabetes risk significantly increases for FPG values within the normal range.31”
From Prediabetes: a high-risk state for diabetes development (2012) · cites this paper as [31]
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“These values may need to be modified for particular ethnic groups (eg, groups of Asian origin) (2) and to become more restrictive according to recent reports of an increased risk of type 2 diabetes at glucose concentrations 100 mg/dL (3).”
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“Higher FPG levels have been shown to be an independent risk factor for developing type 2 diabetes even when subjects are within the normoglycemic range [9,10].”
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“more (22,23), we considered a participant who was diagnosed with”
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“The 5% decrease in FPG herein exceeds and matches effects of metformin and Olristat, respectively, in similar intervention trials in overweight/obese subjects (45; 46), Decrease in FPG in the normal range is associated with reduced risk of developing type 2 diabetes (47).”
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“It has been shown that higher fasting plasma glucose levels within the normal glycemic range constitutes an independent risk factor for T2DM among young men (36).”
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“6 mmol/L (100 mg/dL) are associated with a graded risk for type 2 diabetes (41).”
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“In addition, an elevated glucose concentration per se is a strong predictor of future T2D (5,13).”
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“Different from reference data derived from epidemiologic studies of large populations (18), the present study completed glucose measurement under routine living conditions,”
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Lee, W., Lee, E. S., Kim, J. H., Park, S. E., Park, C., Oh, K.-W., Park, S., Rhee, E., & Lee, W. (2016) · PLoS ONE · doi:10.1371/journal.pone.0163465 · Cited by 130
Association of Genetic Loci With Glucose Levels in Childhood and Adolescence
Barker, A., Sharp, S. J., Timpson, N. J., Bouatia-Naji, N., Warrington, N. M., Kanoni, S., Beilin, L. J., Brage, S., Deloukas, P., Evans, D. M., et al. (2011) · Diabetes · doi:10.2337/db10-1575 · Cited by 117
“Elevated fasting glucose levels within the normal nondiabetic range predict future risk of diabetes (1,2) and are associated with incident cardiovascular disease in nondiabetic individuals (3).”
BackgroundDiabetes Risk Among Overweight and Obese Metabolically Healthy Young Adults
Twig, G., Afek, A. B., Derazne, E., Tzur, D., Cukierman‐Yaffe, T., Gerstein, H. C., & Tirosh, A. (2014) · Diabetes Care · doi:10.2337/dc14-0869 · Cited by 116
Self-citationBiological Factors in the Pathogenesis of Rotator Cuff Tears
Maffulli, N., Longo, U. G., Berton, A., Loppini, M., & Denaro, V. (2011) · Sports Medicine and Arthroscopy Review · doi:10.1097/jsa.0b013e3182250cad · Cited by 116
Platelet Microparticles Mediate Glomerular Endothelial Injury in Early Diabetic Nephropathy
Zhang, Y., Ma, K. L., Gong, Y. X., Wang, G. H., Hu, Z. B., Liu, L., Lü, J., Chen, P. P., Lu, C., Ruan, X. Z., et al. (2018) · Journal of the American Society of Nephrology · doi:10.1681/asn.2018040368 · Cited by 118
Characterization and Heritability of Obesity and Associated Risk Factors in Vervet Monkeys
Kavanagh, K., Fairbanks, L. A., Bailey, J. N., Jorgensen, M. J., Wilson, M. D., Zhang, L., Rudel, L. L., & Wagner, J. D. (2007) · Obesity · doi:10.1038/oby.2007.199 · Cited by 110
“Incident diabetes risk increases with increasing fasting glucose concentrations even within the normal range (34), so establishment of species-specific reference values as described here will allow detection of individuals with marginally elevated glucose values, along with other risk factors for MS.”
BackgroundGenetic and Environmental Interactions in Obesity and Type 2 Diabetes
Romao, I., & Roth, J. (2008) · Journal of the American Dietetic Association · doi:10.1016/j.jada.2008.01.022 · Cited by 114
Higher fasting plasma glucose levels within the normoglycaemic range and rotator cuff tears
Longo, U. G., Franceschi, F., Ruzzini, L., Spiezia, F., Maffulli, N., & Denaro, V. (2008) · British Journal of Sports Medicine · doi:10.1136/bjsm.2008.049320 · Cited by 109
Riskin‐Mashiah, S., Damti, A., Younes, G., & Auslender, R. (2010) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2010.05.036 · Cited by 107
“, <100 mg/dl) constitute an independent risk factor for the development of type 2 diabetes mellitus within a few years [16].”
BackgroundPredictors of new onset diabetes after renal transplantation
Joss, N., Staatz, C. E., Thomson, A. H., & Jardine, A. G. (2007) · Clinical Transplantation · doi:10.1111/j.1399-0012.2006.00580.x · Cited by 102
“In healthy individuals, fasting plasma glucose concentrations in the upper range of normal are associated with the development of type 2 diabetes mellitus (20).”
BackgroundNguyen, Q. M., Srinivasan, S. R., Xu, J.-H., Chen, W., & Berenson, G. S. (2010) · Archives of Pediatrics & Adolescent Medicine · doi:10.1001/archpediatrics.2009.268 · Cited by 93
Fasting glucose levels within the high normal range predict cardiovascular outcome
Shaye, K., TIROSH, A., Segev, S., & Sidi, Y. (2012) · American Heart Journal · doi:10.1016/j.ahj.2012.03.023 · Cited by 103
“d 6-year follow-up study.(2) Although there is a wealth of epidemiological data on the correlation between fasting plasma glucose (FPG) and DM risk, its association with cardiovascular disease (CVD) risk is less clear.”
Self-citationGlyoxalase 1 Modulation in Obesity and Diabetes
Rabbani, N., & Thornalley, P. J. (2019) · Antioxidants & Redox Signaling · doi:10.1089/ars.2017.7424 · Cited by 102
“The increase in OGIS of obese subjects was + 58 mL/min/m 2 , which is a change similar to that found with pharmaceutical treatment of patients with T2DM ( e.g. , 1.7 g metformin per day, D OGIS = + 54 mL/min/m 2 ) (82) and extreme weight loss with gastric band surgery in morbid obesity ( D OGIS = + 62 mL/min/m 2 ) (72…”
InfluentialNguyen, Q. M., Srinivasan, S. R., Xu, J.-H., Chen, W., Kieltyka, L., & Berenson, G. S. (2009) · Diabetes Care · doi:10.2337/dc09-1635 · Cited by 102
Chiu, C., Milton, R. C., Gensler, G. R., & Taylor, A. (2007) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/86.1.180 · Cited by 101
Classification and Diagnosis of Diabetes
GENUTH, S. M., Palmer, J. P., & Nathan, D. M. (2018) · Cited by 95
Ibrahim, N. K., Mahnashi, M., Aldhaheri, A., Al-Zahrani, B., Al-Wadie, E., Aljabri, M. K., Alshanketi, R. M., Alshehri, R. S., Al-Sayes, F. M. O., & Bashawri, J. (2014) · BMC Public Health · doi:10.1186/1471-2458-14-411 · Cited by 93
“BMI was then divided into normal (< 25), overweight (25 - < 30), and obese (≥ 30) [13].”
BackgroundLin, J., & Curhan, G. C. (2010) · Clinical Journal of the American Society of Nephrology · doi:10.2215/cjn.03260410 · Cited by 94
“Because the onset of abnormalities in glucose handling can precede the diagnosis of type 2 diabetes by 10 years or more (23,24), we considered a participant who was diagnosed with diabetes up through the year 2000 as having diabetes.”
BackgroundHsueh, W., McLellan, K., Wyne, K., & Villagomez, E. (2014) · Therapeutics and Clinical Risk Management · doi:10.2147/tcrm.s39564 · Cited by 91
“Furthermore, different cohort studies indicate that diabetes risk increases at a fasting plasma glucose (FPG) below currently recommended thresholds for diagnosis of prediabetes.(34,35) The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus examined the sensitivity and specificity of a wide rang…”
Catalase Deficiency and Type 2 Diabetes
Góth, L. (2008) · Diabetes Care · doi:10.2337/dc08-1607 · Cited by 91
Takeuchi, F., Katsuya, T., Chackrewarthy, S., Yamamoto, K., Fujioka, A., Serizawa, M., Fujisawa, T., Nakashima, E., Ohnaka, K., Ikegami, H., et al. (2009) · Diabetologia · doi:10.1007/s00125-009-1595-1 · Cited by 90
“Fasting plasma glucose (FPG) levels are associated with the future risk of type 2 diabetes and cardiovascular diseases [ 1 , 2] and are tightly regulated despite considerable variation in food intake [3].”
BackgroundLotta, L. A., Abbasi, A., Sharp, S. J., Sahlqvist, A., Waterworth, D. M., Brosnan, J. M., Scott, R. A., Langenberg, C., & Wareham, N. J. (2015) · Diabetes Care · doi:10.2337/dc15-1218 · Cited by 89
Zelber‐Sagi, S., Lotan, R., Shibolet, O., Webb, M., Buch, A., Nitzan, D., Halpern, Z., Santo, E., & Oren, R. (2013) · Liver International · doi:10.1111/liv.12200 · Cited by 88
“of higher fasting plasma glucose levels within the normoglycaemic range, of 91–99 mg/dl, has been demonstrated before to independently increase DM risk (44).”
BackgroundLee, C., Colagiuri, S., Woodward, M., Gregg, E. W., Adams, R. J., Azizi, F., Gabriel, R., Gill, T. K., González, C., Hodge, A. M., et al. (2019) · BMJ Open Diabetes Research & Care · doi:10.1136/bmjdrc-2019-000794 · Cited by 90
Bozorgmanesh, M., Hadaegh, F., Ghaffari, S., Harati, H., & Azizi, F. (2010) · European Journal of Public Health · doi:10.1093/eurpub/ckq074 · Cited by 82
The Prediabetic Period: Review of Clinical Aspects
Rhee, S. Y., & Woo, J. (2011) · Diabetes & Metabolism Journal · doi:10.4093/dmj.2011.35.2.107 · Cited by 78
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White Blood Cell Count and the Risk for Coronary Artery Disease in Young Adults
Twig, G., Afek, A. B., Shamiss, A., Derazne, E., Tzur, D., Gordon, B., & Tirosh, A. (2012) · PLoS ONE · doi:10.1371/journal.pone.0047183 · Cited by 73
“…Life-Style, and Nutrition Assessment in Young Adults (MELANY) Cohort has been conducted at the Israel Defense Forces Staff Periodic Examination Center (SPEC) to which all career service personnel older than 25 years of age are referred every three to five year as described previously [20– 24].”
MethodSelf-citationCognitive Function and the Risk for Diabetes Among Young Men
Twig, G., Gluzman, I., Tirosh, A., Gerstein, H. C., Yaniv, G., Afek, A. B., Derazne, E., Tzur, D., Karasik, A., Gordon, B., et al. (2014) · Diabetes Care · doi:10.2337/dc14-0715 · Cited by 72
Self-citationAcatalasemia and diabetes mellitus
Góth, L., & Nagy, T. (2012) · Archives of Biochemistry and Biophysics · doi:10.1016/j.abb.2012.02.005 · Cited by 73
Bock, G., Man, C. D., Micheletto, F., Basu, R., Giesler, P. D., Laugen, J. M., Deacon, C. F., Holst, J. J., TOFFOLO, G. M., Cobelli, C., et al. (2009) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2009.03764.x · Cited by 71
“Impaired fasting glucose (IFG) confers a high risk of progression to diabetes [1].”
BackgroundRisk of malignancy in women with systemic lupus erythematosus.
Dm, S., Manzi, S., Janosky, J. E., Kj, S., Ferri, W. A., Ta, M., & Ramsey‐Goldman, R. (1995) · PubMed · Cited by 71
Perreault, L., & Færch, K. (2013) · Journal of Diabetes and its Complications · doi:10.1016/j.jdiacomp.2013.10.008 · Cited by 82
“8 mmol/L) is associated with an increased risk of future diabetes (Tirosh et al. 2005).”
BackgroundThe potential of novel biomarkers to improve risk prediction of type 2 diabetes
Herder, C., Kowall, B., Tabák, Á. G., & Rathmann, W. (2013) · Diabetologia · doi:10.1007/s00125-013-3061-3 · Cited by 70
“Although a clearly increased diabetes risk can be observed for individuals with isolated IFG and those with isolated IGT, the categorisation of individuals as either ‘normal’ or ‘prediabetic’ (IFG, IGT) neglects the fact that a significant increase in diabetes risk also exists for increasing fasting glucose levels wit…”
Controversies in stable coronary artery disease
Opie, L. H., Commerford, P., & Gersh, B. J. (2006) · The Lancet · doi:10.1016/s0140-6736(06)67927-0 · Cited by 69
Metadata
- Authors
- Tirosh, A., Shai, I., Tekes-Manova, D., Israeli, E., Pereg, D., Shochat, T., Kochba, I., & Rudich, A.
- Affiliations
- Sheba Medical Center (IL)
- Israel Defense Forces Medical Corps (IL)
- Meir Medical Center (IL)
- Ben-Gurion University of the Negev (IL)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2005-10-06
- Volume
- 353
- Issue
- 14
- Pages
- 1454-1462
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2022852506
- Semantic Scholar
- 6bb2371f0d6168ca3c8b7a7910714ce03e565a83
- Cited by
- 508
- References
- 37
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 17 · 2023: 28 · 2022: 11 · 2021: 17 · 2020: 24 · 2019: 15 · 2018: 24 · 2017: 14 · 2016: 24 · 2015: 21 · 2014: 33 · 2013: 35 · 2012: 31
- FWCI
- 21.52
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- fasting blood glucose, type 2 diabetes, prediabetes, young men, diabetes risk prediction, serum triglycerides, body mass index, hypertriglyceridemia, military personnel, new-onset diabetes
- MeSH terms
- Adult, Blood Glucose, Diabetes Mellitus, Type 2, Fasting, Follow-Up Studies, Humans, Male, Middle Aged, Reference Values, Risk Factors, Triglycerides, Body Mass Index, Multivariate Analysis, Proportional Hazards Models
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